A decade ago, scientists would have laughed at the idea of Ebola as a public health emergency of international concern. Today, they are shocked at the glaring gaps the deadly virus has exposed in the global response to the current outbreak.

Ebola, a rare tropical disease, has killed almost as many people in 6 months as in the previous 40 years. Experimental vaccines and treatments are available, but months away from use by the estimated 30,000 people who could have benefited from them, according to Nature magazine.

"I would have laughed if you had said Ebola would be a global public health emergency," said David Heymann, who was working with the CDC team when the deadly virus was first recorded close to the River Ebola in Democratic Republic of Congo, then Zaire. "Ebola outbreaks can be stopped with a robust response."

Since 1976, 25 Ebola outbreaks have occurred throughout Africa. Most of them were contained within the locality of patient zero - the first person to be infected when the virus jumped to humans from animals, as it does periodically.

That changed in March when the deadly Zaire strain was confirmed in Gueckedou, a small town in southern Guinea. Since then, it has killed over 1,350 people across West Africa, spanning hundreds of kilometres from Guinea to Nigeria.

"There is a whole series of issues in terms of recognition by health workers, a system in which to report, then the need to take the data and act on it, and there have been weaknesses in Guinea in all three of those areas," said Heymann, adding that fear and cultural practices are also part of the challenge.

A similar situation prevailed in Sierra Leone and Liberia, but decades of civil war and corruption resulting in weak health systems meant their governments couldn't face the threat alone. Criticism has emerged of the World Health Organization (WHO), the United Nations' lead agency in fighting disease.

Heymann, who is currently at the London School of Hygiene and Tropical Medicine, said he was disappointed with the WHO response to the Ebola outbreak. West African nations and aid organisations have been less restrained in their criticism.

"BOILING FROG EFFECT"

Brice de la Vigne, Head of Operations for medical charity Medecins sans Frontieres (MSF), told Thomson Reuters Foundation the slow pace at which the WHO reacted to the rapidly escalating Ebola epidemic in West Africa was like boiling a frog.

"Even though we were screaming at them to gear up and scale up, the WHO did not realise they needed to change their approach to being fully in emergency mode, and not just in support mode," said de la Vigne.

"It's the boiling frog effect. If you put a frog in cold water and start to heat it, she will not jump out of the pan, she will adapt to the temperature and she will not realise that she is boiling to death. WHO is the same," said de la Vigne.

In April, MSF said the current outbreak was unprecedented in its geographical scale and needed urgent international action, prompting a very public spat played out on Twitter, where the WHO accused the medical charity of causing panic.

On August 8, WHO declared Ebola a public health emergency of international concern. Fifty people were sent to help with contact tracing, disease surveillance, laboratory work, logistics, information-sharing and social mobilization -- but no doctors, nurses or equipment.

"We need water and sanitation technicians, logisticians, cars, generators, tents, supplies, nurses and doctors, nurses especially. We need the whole apparatus to be able to deploy activities in the field in a difficult landscape like jungle and slums," said de la Vigne.

OK, the "boiling frog" metaphor is an inaccurate cliché. Still, I can sympathize with both sides.

MSF is the NGO I've contributed to for a decade because they know their stuff and they do not suffer fools gladly; fools to MSF are just another health hazard. They're the commandoes of global health, and I have yet to see them kick an ass that didn't deserve it.

But WHO is the Supreme Court, the doctor that prescribes for the whole world. Its people got there by being good doctors and good politicians. Margaret Chan runs WHO in large part because she was smart and tough enough in the first H5N1 outbreak in 1997-98 to order the eradication of all poultry in Hong Kong. She may well have saved us all from ending the century with an old-fashioned, 1918-style pandemic.

She also presided over the official declaration of H1N1 flu as a pandemic. It was indeed that, but the absence of zombies in the streets triggered a backlash that must have hurt. Never mind the hundreds of thousands who died and did not return as zombies.

So I can understand WHO's slowness to cry wolf last spring, when its patients globally are still somewhere in the 12th century, looking for talismans like salt water and terrified of routine childhood vaccinations. The seven billion of us who have entered the 21st century have not exactly been marching in step. Expecting rural West Africans to understand modern medicine is like expecting your teenager to think about saving for her old age.

I am very unhappy that Ebola has hijacked my blog, while a host of other miseries blithely carry on: chikungunya, cholera, MERS, and all the ugly flavours of bird flu. But I'll give the stupid virus this much: Like the 2x4 applied to the head of the trainee mule, it has got our attention. We begin to dimly understand that the afflictions of poor black folk in West Africa are utterly non-racist. They will afflict us with equal and unbiased enthusiasm.

If we are as smart and swift as MSF, and as temperate and deliberate as WHO, we might just make the battle against Ebola the First World War for global health.

A decade ago, scientists would have laughed at the idea of Ebola as a public health emergency of international concern. Today, they are shocked at the glaring gaps the deadly virus has exposed in the global response to the current outbreak.

Ebola, a rare tropical disease, has killed almost as many people in 6 months as in the previous 40 years. Experimental vaccines and treatments are available, but months away from use by the estimated 30,000 people who could have benefited from them, according to Nature magazine.

"I would have laughed if you had said Ebola would be a global public health emergency," said David Heymann, who was working with the CDC team when the deadly virus was first recorded close to the River Ebola in Democratic Republic of Congo, then Zaire. "Ebola outbreaks can be stopped with a robust response."

Since 1976, 25 Ebola outbreaks have occurred throughout Africa. Most of them were contained within the locality of patient zero - the first person to be infected when the virus jumped to humans from animals, as it does periodically.

That changed in March when the deadly Zaire strain was confirmed in Gueckedou, a small town in southern Guinea. Since then, it has killed over 1,350 people across West Africa, spanning hundreds of kilometres from Guinea to Nigeria.

"There is a whole series of issues in terms of recognition by health workers, a system in which to report, then the need to take the data and act on it, and there have been weaknesses in Guinea in all three of those areas," said Heymann, adding that fear and cultural practices are also part of the challenge.

A similar situation prevailed in Sierra Leone and Liberia, but decades of civil war and corruption resulting in weak health systems meant their governments couldn't face the threat alone. Criticism has emerged of the World Health Organization (WHO), the United Nations' lead agency in fighting disease.

Heymann, who is currently at the London School of Hygiene and Tropical Medicine, said he was disappointed with the WHO response to the Ebola outbreak. West African nations and aid organisations have been less restrained in their criticism.

"BOILING FROG EFFECT"

Brice de la Vigne, Head of Operations for medical charity Medecins sans Frontieres (MSF), told Thomson Reuters Foundation the slow pace at which the WHO reacted to the rapidly escalating Ebola epidemic in West Africa was like boiling a frog.

"Even though we were screaming at them to gear up and scale up, the WHO did not realise they needed to change their approach to being fully in emergency mode, and not just in support mode," said de la Vigne.

"It's the boiling frog effect. If you put a frog in cold water and start to heat it, she will not jump out of the pan, she will adapt to the temperature and she will not realise that she is boiling to death. WHO is the same," said de la Vigne.

In April, MSF said the current outbreak was unprecedented in its geographical scale and needed urgent international action, prompting a very public spat played out on Twitter, where the WHO accused the medical charity of causing panic.

On August 8, WHO declared Ebola a public health emergency of international concern. Fifty people were sent to help with contact tracing, disease surveillance, laboratory work, logistics, information-sharing and social mobilization -- but no doctors, nurses or equipment.

"We need water and sanitation technicians, logisticians, cars, generators, tents, supplies, nurses and doctors, nurses especially. We need the whole apparatus to be able to deploy activities in the field in a difficult landscape like jungle and slums," said de la Vigne.

OK, the "boiling frog" metaphor is an inaccurate cliché. Still, I can sympathize with both sides.

MSF is the NGO I've contributed to for a decade because they know their stuff and they do not suffer fools gladly; fools to MSF are just another health hazard. They're the commandoes of global health, and I have yet to see them kick an ass that didn't deserve it.

But WHO is the Supreme Court, the doctor that prescribes for the whole world. Its people got there by being good doctors and good politicians. Margaret Chan runs WHO in large part because she was smart and tough enough in the first H5N1 outbreak in 1997-98 to order the eradication of all poultry in Hong Kong. She may well have saved us all from ending the century with an old-fashioned, 1918-style pandemic.

She also presided over the official declaration of H1N1 flu as a pandemic. It was indeed that, but the absence of zombies in the streets triggered a backlash that must have hurt. Never mind the hundreds of thousands who died and did not return as zombies.

So I can understand WHO's slowness to cry wolf last spring, when its patients globally are still somewhere in the 12th century, looking for talismans like salt water and terrified of routine childhood vaccinations. The seven billion of us who have entered the 21st century have not exactly been marching in step. Expecting rural West Africans to understand modern medicine is like expecting your teenager to think about saving for her old age.

I am very unhappy that Ebola has hijacked my blog, while a host of other miseries blithely carry on: chikungunya, cholera, MERS, and all the ugly flavours of bird flu. But I'll give the stupid virus this much: Like the 2x4 applied to the head of the trainee mule, it has got our attention. We begin to dimly understand that the afflictions of poor black folk in West Africa are utterly non-racist. They will afflict us with equal and unbiased enthusiasm.

If we are as smart and swift as MSF, and as temperate and deliberate as WHO, we might just make the battle against Ebola the First World War for global health.